The impact of ageing-in-place reforms on the provision of home care packages for older Australians, 2008-21: a repeated cross-sectional study.

Autor: Schwabe J; Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA.; University of South Australia, Adelaide, SA., Caughey GE; Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA.; University of South Australia, Adelaide, SA., Wesselingh SL; South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA., Whitehead C; Southern Adelaide Local Health Network, SA Health, Adelaide, SA., Visvanathan R; The University of Adelaide, Adelaide, SA., Evans K; Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA.; The University of Adelaide, Adelaide, SA., Inacio MC; Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA.; University of South Australia, Adelaide, SA.
Jazyk: angličtina
Zdroj: The Medical journal of Australia [Med J Aust] 2024 Sep 02; Vol. 221 (5), pp. 264-269. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.5694/mja2.52405
Abstrakt: Objectives: To assess changes following the 2013-21 Home Care Package (HCP) reforms in the rate of HCPs provided to Australians aged 65 years or older, the characteristics of people who have received HCPs, and the capacity of the program to meet demand for its services during 2018-21.
Study Design: Repeated cross-sectional population-based study; analysis of Australian Institute of Health and Welfare GEN Aged Care and Australian Department of Health Home Care Packages program data.
Setting, Participants: HCPs provided to non-Indigenous Australians aged 65 years or older, 2008-09 to 2020-21.
Main Outcome Measures: Changes in age- and sex-standardised HCP rates (number per 1000 older people) and changes in proportions of recipients for selected characteristics, 2013-14 to 2020-21, overall and by care level; correspondence of proportional HCP supply and demand, 2018-19 to 2020-21, by care level.
Results: A total of 490 276 HCPs were provided during 2008-21. The age- and sex-standardised HCP rate rose from 9.23 per 1000 people aged 65 years or more in 2013-14 to 16.4 per 1000 older people in 2020-21. The increases in age- and sex-standardised HCP rate between 2013-14 and 2020-21 were greatest for level 1 (from 0.19 to 5.05 per 1000 older people) and level 3 HCPs (from 0.35 to 3.62 per 1000 older people); the rate for level 2 HCPs declined from 6.75 to 5.82 per 1000 older people, and that for level 4 HCPs did not change. The proportion of culturally and linguistically diverse recipients rose from 10.8% to 16.2%; the overall proportion of recipients living outside major cities rose slightly, from 28.1% to 28.7%, but declined for higher care level HCPs (level 3: from 30.8% to 27.8%; level 4: from 29.6% to 25.2%). During 2018-19 to 2020-21, the proportions of lower level (1 and 2) HCPs generally exceeded demand, while the supply of higher level (3 and 4) HCPs generally fell short of demand.
Conclusions: Despite the increased overall availability of HCPs, the supply of higher care level HCPs is still lower than the demand, probably contributing to suboptimal support for the ageing-in-place preferences of older Australians, especially in regional and remote areas.
(© 2024 The Author(s). Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)
Databáze: MEDLINE
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